Provider Demographics
NPI:1487097317
Name:SERENITY SOLUTIONS, LLC
Entity type:Organization
Organization Name:SERENITY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:419-232-6010
Mailing Address - Street 1:140 FOX RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-2475
Mailing Address - Country:US
Mailing Address - Phone:419-232-6010
Mailing Address - Fax:419-232-6012
Practice Address - Street 1:140 FOX RD
Practice Address - Street 2:SUITE 303
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-2475
Practice Address - Country:US
Practice Address - Phone:419-232-6010
Practice Address - Fax:419-232-6012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6909103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty